This presentation answers the question 'Why do sexual and reproductive health and rights (SRHR) matter?', drawing on data generated on the social and economic costs of unsafe abortion in Zambia. The presentation was made to members of the Present Purpose Network (PNN), an organisation of female practitioners and policy makers working to find solutions to problems that impact young women and their local and international communities. The meeting brought together about 20 women from Asia, Europe and N America online for an audio and visual e-conference.

1. Why do sexual and reproductive
health and rights (SRHR) matter?
Dr Ernestina Coast
e.coast@lse.ac.uk
http://personal.lse.ac.uk/coast/
Presentation to PPN 25/4/15

2. WHAT ARE THE CONSEQUENCES OF
NOT MEETING SRH NEEDS?

3. ZAMBIAN WOMEN WE INTERVIEWED
HTTPS://ZAMBIATOP.WORDPRESS.COM

4. Contraceptive failure
A 32 year old married woman with four children. She is a very
poor woman who is struggling with the up-keep of her four
children. The husband depends on piece work to feed them.
She does some work like washing of clothes just to earn some
money for food.
She was surprised to find out that she was pregnant because
she was on a three months injectable contraceptive.
The reason for attempting to terminate the pregnancy was
because the cost of raising children is very expensive and
already she was unable to send her four children to school.
She had no money to even feed the family and so why would
she have another child?

5. She is a 26 year old married woman with three
children, the youngest of which is 7 months old. She
runs a small business, baking scones which she sells
in her shop. She went to the clinic to start her
family planning pill but she was told to come back
when her periods start, and was not given any
contraceptive supplies.
She did not know that safe termination was legal in
Zambia and self-induced a termination using
unspecified pills.
She intends to have a normal life when she goes
home and wants to start her family planning pills.
Poor access to contraception

9. 73
40
31
65
35
25
60
32
23
53
30
19
46
29
19
Sub-Saharan Africa Asia* Latin America and the
Caribbean
Poorest Poor Middle Rich Richest
% of women wanting to avoid pregnancy who have an unmet need, 2014
100
Levels of unmet need for modern contraception
are highest among the poorest women
Wealth quintile:
*Excludes Eastern Asia and Oceania

10. 26%
The 26% of women who want to avoid pregnancy and are not
using modern contraceptives account for 81% of unintended
pregnancies
81%
877 million women wanting to
avoid pregnancy
74 million unintended
pregnancies

12. Pregnancy-related care increased, 2008–2014, but
millions of women still lack essential services
63
71 68
82
60 54 55
43
2008 2014 2008 2014
Unmet need
Received
care
No. of women giving birth (millions)
125123125123
Facility delivery4+ antenatal care visits
(51%) (57%) (55%) (66%)

17. QUESTIONS?